A case of reversible paraparesis following celiac plexus block

Background and Objectives: Permanent and acute reversible paraplegia follow ing celiac plexus block (CPB) have been reported. We report a case of prolo nged reversible paraparesis after alcohol celiac plexus block. Case Report: A 72-year-old man with primary multicentric pancreatic tumor a nd multiple hepatic metastases underwent alcohol celiac plexus neurolysis f or severe abdominal pain radiating to the back. The patient had complete pa in relief after the block but developed paresthesia of the left leg, which then spread to the right leg. Subsequently, loss of flexion and extension o f the muscles supplying the left hip, knee, and foot developed. Deep tendon reflexes were brisk on the left compared to the right, and both plantar re flexes gave flexor responses. Magnetic resonance imaging and myelography we re normal. Motor-evoked potential recordings showed a spinal cord lesion wi th involvement of the pyramidal and spinothalamic tracts. Somatosensory-evo ked potentials indicated a relative sparing of dorsal column pathways. Phys iotherapy was started, the sensory changes gradually subsided, and the pati ent was discharged 30 days after the block with clinically insignificant ne urological deficit. Conclusions: Paraparesis following alcohol celiac plexus block may be rever sible over an extended period of time.